Using a Hospital Quality Improvement Toolkit to Improve Performance on the AHRQ Quality Indicators

Quality of care in U.S. hospitals is a significant problem. The pace of quality improvement efforts in hospitals has picked up in recent years, with a focus on monitoring and public reporting of quality information. Prominent among such tools are quality indicators (QIs) developed by the Agency for Healthcare Research and Quality (AHRQ), including two sets of indicators for inpatient settings: the Inpatient Quality Indicators (IQIs) and Patient Safety Indicators (PSIs). However, if hospitals lack the needed knowledge, skills, or resources, their efforts to improve performance may have little effect on quality outcomes. Many hospitals may need help to enhance their capacity to use QIs for effective quality improvement. A team from RAND and the University HealthSystem Consortium (UHC) developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality. The team then evaluated participating hospitals' use of the toolkit and whether it improved hospital performance on AHRQ QIS. The evaluation found that improved performance depended on leadership buy-in: Hospitals with board and executive support were able to do more. In addition, the toolkit helped achieve staff consensus on the extent of quality gaps and supported the use of evidence-based practices.